Block Chain a New Frontier for HIM

Block Chain a New Frontier for HIM

This monthly blog highlights and discuss emerging trends and challenges related to healthcare data and its ever changing life cycle.

By Raymound Mikaelian, MSHI, RHIA


Imagine, if you will, a database that houses all the critical components of a patient’s health record, which is actively available to all the stakeholders required to ensure the delivery of quality care—from the patient’s primary care provider to their insurer, urgent care clinics, and acute care hospitals. In addition to accessibility, this database is encrypted, secure, and constantly ensuring its integrity. While health information exchanges struggle with accurate query hit rates, the healthcare industry is eyeing another paradigm shift with block chains.

To better understand block chain, we’re going to take a step back to 2017, where Bitcoin began to make its mark. Fundamentally, Bitcoin is a digital-decentralized ledger storing cryptographic values known as hashes. Hashes are stored in blocks and blocks are chained together to form a block chain. Additionally, each block in a chain contains the hash from previous blocks, which secures the block chain by preventing modification to previous blocks in the chain. The screenshot below illustrates a section from a Bitcoin block chain; there are numerous other resources online if you would like an in depth look at Bitcoin and block chains. As individuals began to better understand the frame work for Bitcoin, the numerous applications for the underlying technology became more and more evident.

For a graphic that provides a visualization of a block chain overview, visit

So why does this all matter to HIM professionals? Block chains allow for the creation of datasets available to numerous stakeholders, who are dependent on positive patient identification, quality data management, and protection of patient privacy. If the healthcare industry adopts block chain technologies, HIM professionals must be at the table to share their expertise.

While block chain technology is still in its infancy, it is growing at an accelerated rate. IBM has been presenting use cases for the block chain since late 2017, which include innovation to community-based care, data sharing, financial transactions, and supply chain management. Additionally, Humana, Optum, UnitedHealth, and Quest Diagnostics announced a collaboration to investigate if use of block chain technologies positively impact healthcare delivery.

Block chain represents only one of many innovations that are constantly introduced into an ever-evolving market. Regardless of where block chain ends up, HIM professionals must be ready to adapt or risk being left behind.


Raymound Mikaelian ( is operations director, health information management at Navigant.

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